Post Incident Care

Many people involved in disaster situations may feel affected by their experiences for a long time after the event, it is therefore important to provide support to these individuals wherever possible.

If you have been involved in a major incident or event, you may find the following guidance helpful. It has been compiled by The Department of Health, using expert clinical advice to document the likely psychological effects of exposure to the trauma of a major incident.

The guidance has been designed to help people cope with their feelings in the immediate aftermath of a major incident and to assist them in deciding whether and when to seek further help.

Coping with the Aftermath of an Emergency: Department of Health Guidance After an incident

Often, major events make us feel that that life is unfair and unsafe. But, looking back afterwards and despite our feelings and problems at the time, it is clear that most people do cope well and recover without long-term problems.

What you have seen and heard is likely to have an effect on you, even if you have not been injured. Coping can be difficult. Everyone is different and each person has his or her own feelings afterwards.

What has happened can cause strong feelings, but, usually, they settle in time.

How you might be affected

Major events are shocking and some of them can be overwhelming. After any major event, it is normal to have feelings and other experiences that may continue for some weeks.

People who are directly involved or who lose loved ones are the people who are likely to be most affected. However, witnesses, friends and relatives may have reactions too.

Immediately afterwards, you might feel:

- Stunned, dazed or numb, cut off from what is going on around you

- Unable to accept what has happened

- That it hasn't really happened

Usually, these feelings fade and others may take their place in the hours or days afterwards. In the following few weeks, you might experience:

- Tears and sadness

- Fear

- Anxiety

- Numbness or dreaminess

- Unpleasant memories about the event

- Problems with your concentration

- Difficulties with your memory

- Difficulties with sleeping, nightmares and tiredness

- Feeling less confident or, sometimes, helpless

- Reduced energy

- Feeling angry or irritable

- Reduced appetite

- Guilt about the incident

- Headaches and other aches and pains

- Feelings of reluctance to discuss the event or you wish to talk about it all the time

- Wanting to avoid people, places or activities that remind you of the event (and this might include travelling on public transport)

- Elation about surviving

Children and young people are as likely to be affected as adults and they may have similar experiences. Often, they become unsettled and more aggressive or fearful and it is usual for them to be more clingy and demanding. Also, they may 're-play' the event in their games. These reactions are understandable and, usually, reduce gradually over time. Parents can help their children by providing both information and reassurance. Like adults, children cope surprisingly well in the longer-term.

What can I do that's helpful? You should:

- Take each day at a time

- Do things that make you feel safe and secure

- Be patient with yourself; it may can take weeks or months to feel that you and your

life are back to normal

- Try to re-establish your usual routines such as going to work or school

- Spend time with family, friends, and others who may be able to help you through this difficult time

- Give reassurance to children to help them to feel safe and to talk about their fears and worries

- Take good care of yourself physically; eat well, exercise regularly, reduce alcohol and drug use and get enough sleep

- Talk it over when you are ready, but, don't worry if you get upset or cry while you think or talk about what happened

- Take extra care; after a major incident or event, people are more likely to have accidents

What isn't helpful?

Bottling up your feelings isn't helpful; let yourself talk when you feel ready.
Alcohol and drugs; while they can numb your feelings, they can also stop you from coming to terms with what has happened or cause more problems later.

Do I need professional help?

Most people who have encountered a major incident find that they get better over time. However, if you are still having difficulties after a month, you might need some help.

The same advice applies to your children; they, too, may benefit from help if their feelings and behaviour are a worry to you a month after the event. It is helpful to seek advice if this is the case. Going to school may be very helpful to children and young people because it re-establishes routines and brings them into contact with friends.

What professional help can I expect?

Advice, help, and treatment aimed at those of all ages to come to terms with an event, by talking about their feelings and learning to cope better. Sometimes, medication is helpful.